Examining Disparities in Perinatal HIV Transmission (Part Two)

In our last article related to perinatal HIV transmission, Examining Disparities in Perinatal HIV Transmission (Part One), we evaluated the various populations that are disproportionately impacted by the transmission of HIV during gestation, delivery, or through breastfeeding. But what about how these populations were impacted by region?

In the data we reported in February 2024, we relied upon data from the Centers for Disease Control and Prevention (CDC), which included the number of children diagnosed between the ages of birth to 12, rather than specifically focusing on confirmed cases of perinatal transmission. Using that same methodology, PlusInc began to examine whether children living in certain regions of the United States were more likely to be diagnosed with HIV.

In examining HIV incidence data from five years of HIV Surveillance Reports covering 2017-2022, we discovered that states in the South accounted for 226 of the 425 total diagnoses of children aged <13—more than half of all diagnoses (CDC, 2020-2024).

5 of the 10 states with the highest incidence of HIV in children were southern states (FL, TX, GA, AL, & VA). Florida had the highest number of diagnoses, accounting for 62—nearly double next highest state, California, with 32. Texas had 31, Georgia had 27, Alabama had 18, and Virginia had 16 (Figure 1).

Figure 1 - HIV Diagnoses in Persons Aged <13 by State, 2017-2022

This disproportionate burden is unsurprising, as HIV, in general, is more prevalent in the southern United States (Figure 2). In 2022, the South accounted for 52% of all HIV diagnoses in the United States.

Figure 2 - Differences in HIV diagnoses by region, 2022

As we highlighted in our February article, Black children were disproportionately more likely to be diagnosed with HIV before age 13 than any other demographic. The American South has the highest concentration of Black Americans in the United States.

One of the primary concerns going forward is that patients living in southern states—particularly those that are more rural—are likely to face continued barriers to accessing testing, as well as preventative and post-transmission treatment for HIV. These barriers include higher levels of poverty, lack of transportation, lack of health literacy, and the inability to access healthcare services, in general, much less those focused on providing prevention and treatment services.

PlusInc will continue to monitor perinatal HIV transmission data to identify any disproportionate impacts.

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Ableism and Inequitable Access to Healthcare

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The Utilization of Race-Based Clinical Algorithms to Make Healthcare Decisions